336 10TH ST - MISC PERMIT (2) PUBLIC UTILITIES PLAN REVIEW COMMENTS
Date: 1,,,l .,,i i c, Initials:
-'- •1/1—
Project Name/Address: .a- L I lgr sr Application Permit#: 1 ( _S _K -7 3 b
Check Box Check
Application Tracking Comments to Add Box to
Comment "Print"
UWSU Avoid damage to underground water/sewer utilities. Verify vertical and horizontal
location of utilities. Hand dig if necessary. If field coordination is needed, call 247-5834. ❑ / ❑
MBSC �/
Ensure all meter boxes, sewer cleanouts and valve covers are set to grade and visible.
RT1C A sewer cleanout must be installed at the property line. Cleanout must be covered with
6/ c('
an RT1 concrete box with metal lid. Cleanout to be set to grade and visible.
RPZB A reduced pressure zone backflow preventer must be installed if irrigation will be
provided or if there is a private well on the property. Backflow preventer must be tested ❑ ❑
by a certified tester and a copy of the results sent to Public Utilities.
STRM Plans note the building will be unsprinkled. If plans change, any fire line installed must be
metered with a Sensus touch-read meter in a properly sized vault and an appropriate ❑ ❑
backflow preventer installed. Backflow preventer must be tested by a certified tester and
a copy of the results sent to Public Utilities.
FSBR If fire sprinkler system is provided, contact Malcolm Clemons at 247-5839 for backflow
❑ ❑
requirements. At a minimum, will require a double check backflow preventer.
FLM Fire lines must be metered with a Sensus touch-read meter. Meters larger than 2" must
be installed in a vault as noted in JEA specifications. ❑ ❑
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MAP SHOWING BOUNDARY SURVEY OF
THE EASTERLY 40.00 FEET OF LOT 17 AND THE WESTERLY 10.0 FEET OF LOT 15, ALL IN BLOCK 12, ACCORDING TO
THE PLAT OF "ATLANTIC BEACH", AS RECORDED IN PLAT BOOK 5, PACE 69 OF 11-IE CURRENT PUBLIC RECORDS OF
DUVAL COUNTY, FLORIDA. -'r,1.AO r.Lr 1rii •r'IYJ
CERTIFIED TO: KATULEEN BULL, NI El.:; 1(11.,1„
FIDELITY NATIONAL TITLE INSURANCE COMPANY AND HIRI(ALTAI( TITLE SERVICES.
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THE PLAT OF "ATLANTIC F)EACII", AS RECORDED IN PLAT BOOK 5, PACE 69 OF THE CURRENT PUBUC RECORDS OF
DUVAL COUNTY, FLORIDA.
CERTIFIED '1'0: fr4u`� '.-•eV-Aria')
KATHLEEN BULL, NIELS RIILJ„
FIDELITY NATIONAL TITLE INSURANCE COMPANY ASH CI KRRAL:14\li 9'1'11K SERV ICES.
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X-REFERENCC JOB NO.: 37267: 37091 ...k.)..,0)m114701 /..oao-A
ROOD 200E'T'-AREAS OelERMNFO TO DC 0,11SKIC IRE 0.2X ANNUAL coma FLOOD M.AM/nom 7.ONE-x(OIAILLl'1)•'-AREAS IY II 7x ANNUAL CHAN(f.MOM;AREAS OF IS ANNUAL
climax WIN AVFRAI.E DEPTHS TT MATS 111AN I FOUL(M/WIN IMUINAA ARIAS 11:S5 THAI I SOUMIL MU;AND AKA'':[All)L(:(II 110 LCHkS FROLI IX ANNUAL 1.I1AIlL FLOOD.
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�,,, ,f' 1.ANGLES ARC SHOWN FOR THIS SURVEY.
0 /��j, 2.SIRIICIURE N0._i 'MOWN IICRE(1 LIES%IIIIIN FLOOD'ZONE__.X._-_AS
PEST DETERMINED MOM F.C.M.A.ILO(X)MAPS PANEL NO._1.,.._IIAILBII4_I/-1089.
SSOCIATED SURVEYORS INC. 3.11115 IS A SURFACE SJIIVEY ONLY. 1HC CXOEN/ Of UNULRGIUOl1I1U FOUIINCS,
/7 / LAND & ENGINEERING SURVEYS PIPES AND UIILIIII:S, IF ANY, NOT IIEIENMINEU.
4.JURISDICTIONAL AND/OR ENVIIloNMENTALLY %NSITIVE MCA II' ANY NOT
,-' , 3846 ()LANDING BOULEVARD LUCAILD UY 11115 S(III 'Y.
s // ,- JACKSONVILLE, FLORIDA 32210 5•THIS SURVEY BASED ON LEGAL DESCRIPTIONS FURNISHED. IIIC PUouC
2 904-771-G46H RECORDS WERE NOT SEARCHED OY 1HIS SURVEYOR FOR CASCML.NTS, TITLE,
Z /J CERTIFICATE. OF AUTITORI7AlION NO. LIT 0005488 CUVLNANIS, B.R.L'S RESTRICTIONS, CLOSURES, TAKINGS OR ORDINANCES, ETC.
S S V THERE COULD DE OTHER MATTERS Of RECORD THAT AFFECT THIS PARCEL.
\ `,�, C.UNLESS OTHERWISE STATED ALL IRON PIPES FOUND IIAVC NO IDENTIFICATION.
�.wJ v� I HEREBY CERTIFY THIS SURVEY WAS DONE UNDER MY LiEGEND/AVIGIVIEVIATIONS
DIRECT SUPERVISION AND MELTS THE MINIMUM TECHNICAL O SET mot;PIPE OR RCDNt I.C. - POINT OF CURVE CH .. CHUM
STANDAR S FOR LAND URVEYING PURSUANT TO CHAPTER "ASSOC.SURVCY"(Xt L0.5488 f;,1......):00)1(1F TAN(ENCY (R)-RLCORII
61617-K FLORIDA ADM ISTF IVF COD I, CHAP ER 472, F.S. • FOUND IRON PIN OR PIPE (IP) . • U R IIGU UIIUIIES(M) - MEASURED
M FOUND CONCRETE MONUMENT(CIO) n - FIRE IIYURANT (C)-COMMUTED DATA
l_\ ln" K- CROSS CUT OR DRILL HOLE CONC. - CONatE If. rt. RADIUS
VV BY: 7 �G./ ��- O.R.D.-OFFICIAL RECORD 0001< A\C -Alll CUNDIII(ulflt
O.It.V.-OFFICIAL RECORD VOLUME. OD -WATER METER L.- ARC LE USER
CH 2L B. BATCH Z / FLORIDA C IFICATE NO. 3771 P.R.M.-PERMANENT REFERENCE ualuuErl( P.EU. -POOL E00IPMF.NF ' wNONE RISER
CH LES L. STARLING(`/ FLORIDA RTIFICATE NO. 4579 O.R.L-BUILDING RESTRICTION LINE X-X
CHAIN LINK FENCE K/W-RICNT OF MAY
l RAYMOND J. SCHAEFE. FLORIDA CERTIFICATE NO. 6132 F.T. 'ELECTRIC 1RANSFORMER&PAO W-W N1RL FENLY D.T.. BUILDING TIE
'J.E.A.-JACKSONVILLE ELECTRIC AUTHORITY l7-ll WUW FENCE `G- UTILITY POLE
JOB NO. 56099 DATE 03-05-2009 C&R - COVENANTS h RESTRICTIONS 'I-I'01011 FENCE GUY ANCHOR `
P.C.C. -POINT OF COMPOUND CURVE WIN. -BETWEEN COY() - COVERED
SCALE: 1" = 20 DRAFTER_ .774 9�J(l!'4_ r,l<.(. - POINT(x REVERSE CURVE (E.L)- CAVE TIE c.o.-ELECTRIC BOX
NOT VALID WITHOUT THE SIGNATURE AND THE ORIGINAL RAISED SEAL OF A FLORIDA LICENSED SURVEYOR AND MAPPER
•
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`' CITY OF ATLANTIC BEACH
' A T CONSTRUCTION PERMIT WITHIN CITY RIGHTS OF WAY AND EASEMENTS
800 Seminole Road
CM S'' Atlantic Beach,Florida 32233-5445 904-247-58
Fax 904-247-5845
PLEASE SUBMIT(2)COMPLETE SETS OF PLANS WITH APPLICATION. PERMIT#
Date 3 3 u - Zv ( 6 ISSUES BY THE CITY
Job Address 3 3 G h S i i2-I j E-mail
Permitee: Telephone#
Permitee Address:
Requesting Permission to Construct:
Location: (Reference to Cross-Street)
1. Applicant declares that prior to filing this application he has ascertained the location of all existing utilities, both
aerial and underground and the accurate locations are shown on the sketches.
A Letter of Notification was mailed to the following Utilities/Municipalities:
Jacksonville Electric Authority Yes ( ) No ( ) Date:
Bell South Telephone Company Yes ( ) No ( ) Date:
Ferrell Gas Yes( ) No( ) Date:
Comcast
Yes ( ) No ( ) Date:
2. Whenever necessary for the construction, repair, improvement, maintenance, safe and efficient operation,
alteration or relocation of all, or any portion of said street or easement as determined by the Director of Public
Works, any or all of said poles, wires, pipes, cables or other facilities and appurtenances authorized hereunder,
shall be immediately removed from said street or easement or reset or relocated hereon as required by the
Director of Public Works, and at the expense of the Permitee unless reimbursement is authorized.
3. All work shall meet City of Atlantic Beach or Florida Department of Transportation Standards and be performed
under the supervision of (Contractor's Project Superintendent)
located at Telephone#:
4. All materials and equipment shall be subject to inspection by the Director of Public Works or his designee.
5. All city property shall be restored to its original condition as far as practical, in keeping with city specifications and
the manner satisfactory to the city.
6. A sketch of plans covering details of this installation, as well as, a copy of a recent survey shall be made a part of
this permit. Calculations showing any increase in impervious area on owner's lot or in the city Right of
Way are to be included with this application.
7. This permittee shall commence actual construction in good faith with days. If the beginning date is more
than 60 days from date of permit approval, then permittee must review the permit with the Director of Public
Works to make sure no changes have occurred in the area that would affect the permitted construction.
8. It is understood and agreed that the rights and privileges herein set out are granted only to the extent of the City's
right, title and interest in the land to be entered upon and used by the holder, and the Holder will, at all times,
assume all risk of and indemnify, defend, and save harmless the City of Atlantic Beach from and against any and
all loss, damage, and cost of expenses arising in any manner of the exercise or attempted exercises by the holder
of the aforesaid rights and privileges.
9. The Director of Public Works shall be notified twenty-four(24) hours prior to starting work and again immediately
upon completion.
OWNER
Signed: Date: Before me this day
of in the County of Duval, State Of Florida, has personally appeared
Notary Public at Large, State of Florida, County of Duval. My
commission expires: Personally Known:
Produced Identification:
Revised 7/29/15
/fr/e4 P u // 2.'-3<)5- 7 3
N0 .8 eNofZDnAmv 5i9 .
Permit Attachment of for
Permit# issued ,20_Atlantic Beach,FL 32233
Owner's Name:NMet-5 'BULL Property Address:33G Teivrti s!, Ari,t,i c.
R.E.#:
3 17.- 3
Subdivision: Lot#/Block#:
REVOCABLE ENCROACHMENT PERMIT
THIS REVOCABLE ENCROACHMENT PERMIT,issued on this 3o day of /`'I V v( ,20I‘
by Atlantic Beach, Florida, a municipal corporation organized and e 'sting under the laws of the State of
Florida, hereinafter referred to as "CITY" and Niel, A 1 of Atlantic Beach, Florida,
hereinafter referred to as"USER".
WITNESSETH:
That the CITY does hereby grant the USER permission on a revocable basis as described herein the right to
enter upon the property of the City of Atlantic Beach for the purpose as described in the City of Atlantic
Beach Right-of-Way/Easement permit numbers noted above(copies attached).
This work is generally described as:Ak-.-$v/C..a /IV4 ear C� f 4'flAJ /it)a i)i2(t/4 Lo}f.
F/rot-I coovc,247 %v t0ER5
Any facility maintained, repaired, erected, and/or installed in the exercise of the privilege granted remains
subject to relocation or removal on thirty(30) days notice by CITY to the USER, said notice to USER shall be
given by certified Imail, returlav receipt equested, to the following address:
The depositing of said notice of cancellation in the United States mail shall constitute the notice of
cancellation and the burden is upon USER to keep the CITY informed of USER's proper address.
The USER shall promptly make any and all necessary repairs to any facility erected or maintained in the
exercise of the privilege herein granted and shall at all times maintain said facility in good and safe condition.
In the event it is necessary for the CITY or the City's approved representative or other franchised utility to
enter upon the above-described property of the CITY, the USER shall replace at the USER's sole expense,
any and all material necessarily displaced during the action of maintaining, repairing, operating,replacing, or
adding to of the utilities and facilities of the CITY or franchise utility provider.
The facilities allowed by the permit shall meet the current requirements of the City Code, Building Codes,
Land Development Code,and all other land use and code requirements of the CITY, including
City Code Section 19-7(h)which states"Driveways that cross sidewalks: City sidewalks may not be replaced
with other materials, but must be replaced with smooth concrete left natural in color so that it matches the
existing and adjoining sidewalks."
Page 1 of 2
The USER, prior to making any changes from the approved plans and/or method, must obtain written
approval from the City of Atlantic Beach,Public Works Department,for said change. The USER shall,at the
discretion of the CITY, be requested to submit as-built drawings showing the change within thirty (30) days
after the day of completion.
This permit shall insure to the benefit of, and be binding upon, the USER and their respective successors and
assigns.
USER shall meet the terms and conditions of this permit and to all of the applicable State and CITY laws
and/or specifications, to include utilities locate requirements and use limitations/requirements of public
rights-of-way and other public land. USER further agrees that the CITY and its officers and employees shall
be saved harmless by the USER from any of the work herein under the terms of this permit and that all of said
liabilities are hereby assumed by the USER.
DATED and SIGNED this 3 0 day of ti kg 4-f'l 2016
By: i/ „/Z
Property Owner
(to be signed in presence of the Notary)
STATE OF FLORIDA
COUNTY OF DUVAL
On this 3Oday of , 2 nally appeared before me, a Notary Public in
and for said County and State, F (.. o L.4 4_, , the property owner of
3310`i C5 t S- . ,Atlantic Beach,Florida,known to me to be the person(s)described in
and who executed the foregoing instrument; who acknowledged to me that he or she executed the same freely
and voluntarily and for the uses and purposes therein mentioned.
Notary Public in for said County and State C -C -t .(/.CQ
CITY OF ATLANTIC BEACH, FLORIDA, a
municipal corporation: ,
,,": TOM GINDLESPERGER ,_
:4 t .r: MY COMMISSION/FF 924951
Approved: .
;, Z R EXPIRES:October 6,2019
�/ iif,:d`' Bonded ThN Nptry Public Underwriters
r....ea...,
a e Moore,Public Works Director
For Permits where city sidewalk is impacted,
City Manager approval required:
Nelson Van Liere,City Manager
Page 2 of 2